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Author Jittamala, Podjanee ♦ Puthanakit, Thanyawee ♦ Chaiinseeard, Sukrapee ♦ Sirisanthana, Virat
Source CiteSeerX
Content type Text
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Subject Domain (in DDC) Computer science, information & general works ♦ Data processing & computer science
Subject Keyword Virologic Failure ♦ Antiretroviral Therapy ♦ Genotypic Resistance Mutation Pattern ♦ Original Study Predictor ♦ Nnrti-based Art ♦ First Year ♦ Hiv-infected Child ♦ Common Nnrti Mu-tations ♦ Nrti Mutation ♦ Describe Pattern ♦ Common Resistance Mutation ♦ Genotypic Resistance Mutation ♦ Reverse Transcription Inhibitor ♦ Multivariate Analysis ♦ Major Mutation ♦ First-line Regimen ♦ Resistance Mutation ♦ Inclusion Criterion ♦ Second-line Regimen ♦ Multinrti Resistance ♦ Plasma Hivrna ♦ Drug Resistance ♦ Plasma Hiv-1 Rna ♦ Virologic Failure Rate ♦ Early Detection
Abstract based antiretroviral therapy (ART) has been widely used as a first-line regimen for the treatment of HIV. This study aimed to determine the rate and predictors of virologic failure and describe patterns of resistance mutation. Methods: The inclusion criteria were children who were 18 years and receiving NNRTI-based ART. Plasma HIV-1 RNA and CD4 were moni-tored every 6 months. Virologic failure was defined as plasma HIVRNA 1000 copies/mL. Results: Forty (20%) of 202 children had virologic failure, of whom 33 (16%) failed in the first year of therapy. By multivariate analysis, the children who received nevirapine were 3.7 times more likely to develop virologic failure than those receiving efavirenz (P 0.006). The prevalence’s of patients with 1 major mutations conferring drug resistance to nucleoside reverse transcription inhibitors (NRTIs) and NNRTIs were 89 % and 97%, respectively. The common NNRTI mu-tations were Y181C/I (58%) and K103N (34%). The NRTI mutations were M184V/I (84%), K65R (11%), Q151M (5%), and 3 TAMs (3%). Conclusions: The virologic failure rate in children was high and mostly occurred in the first year of treatment. The most common resistance mutations were those conferring resistance to NNRTIs and lamivudine. There were few instances of multiNRTI resistance. Early detection of virologic failure might allow more options for second-line regimens. Key Words: HIV-infected children, NNRTI-based ART, genotypic resistance mutations, virologic failure
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study